Radiofrequency ablation (RFA) is a procedure in which a probe is inserted into the center of a tumor and heated locally by a high frequency, alternating current that flows from electrodes. The local heat treats the tissue adjacent to the probe, resulting in a 3-5 cm sphere of dead tissue. The cells killed by RFA are not removed but are gradually replaced by fibrosis and scar tissue. RFA may be performed percutaneously, laparoscopically, or as an open procedure.
Cryosurgical ablation involves the freezing of target tissues, most often by inserting a probe into the tumor where coolant is circulated. Cryosurgical ablation can be performed as an open surgical technique or percutaneously or laparoscopically, typically with ultrasound guidance.
RFA of primary or metastatic hepatocellular carcinoma (HCC) may be considered medically necessary when ANY of following are met:
RFA for hepatic metastasis is considered experimental/investigational for the following:
RFA of liver tumors is considered experimental/investigational for all other indications due to the lack of scientific evidence to support efficacy and safety and therefore non-covered.
Cryosurgery of the liver, using a FDA-approved cryosurgical device, may be considered medically necessary for select individuals with unresectable liver tumors or for patients whose liver tumors are not totally resectable when ALL of the following criteria are met:
The following uses of cryosurgery of the liver are considered experimental/investigational:
Cryosurgery for liver tumors is considered experimental/investigational for all other indications due to the lack of scientific evidence to support efficacy and safety and is therefore non-covered.
Covered Diagnosis Codes for Procedure Codes 47370, 47380, 47382, 47371, 47381 and 47383